Research and Workforce Development among Oral Health Providers in the Kingdom of Saudi Arabia

1. INTRODUCTION

Dental research significantly contributes to the enhancement of oral health through the generation of novel insights and the dissemination of existing knowledge to those in need [1]. Dental research initiatives are important to continually improve oral health status, whether by producing new knowledge or finding new ways of making the existing knowledge available to those who need it [1]. According to the National Research Council, the field of dentistry continually needs researchers to develop new and better dental technologies. However, the field is being threatened by the small number of researchers doing research in the field [2]. Dental research is defined as the formalized acquisition and investigation of topics related to the dental profession [3]. Furthermore, dental research creates new knowledge and information about the latest innovations related to dentistry, the oral cavity, and the associated structures in oral and health diseases. Pau et al. studied the factors associated with the involvement of dental faculty in research initiatives and postgraduate research training, both of which emerged as significant influences in state-of-the-art dental research and practice [4]. Despite awareness of the importance of research and development in health care, many professionals remain unengaged [5].

The Kingdom is considered among the top-ranked oil-producing countries globally and relies heavily on the oil industry. Therefore, the country can support and improve the general health of its citizens [6]. From 2009 to 2018, Saudi Arabian scholars published 1,771 dental research studies, equating to an average of about 177 publications per year [7]. These studies have collectively amassed 10,320 citations, yielding a citation impact of 5.83. However, this achievement pales in comparison to the United States, which leads with 20,720 publications, followed by Brazil with 12,908, and China with 7,072.

The Research and Development (R&D) index provides an efficient process for determining the strength of an organization’s research and development culture, as it captures the role of both individual practitioners and the organizational environment [8]. The R&D index analysis consists of 16 items in three domains: R&D support, personal skills and aptitude, and intentions toward R&D [9]. The R&D Index can help to determine which units need further encouragement to increase their overall research productivity [5]. Thus, continuous efforts must be made to promote R&D within dental healthcare organizations to address the needs of dental health practitioners as well as their organizations. In addition, R&D has direct implications for the dental health of the general population.

Dental research is a cornerstone for advancing oral healthcare, fostering innovation, and enhancing clinical practices through evidence-based insights. In Saudi Arabia, achieving national healthcare goals and addressing oral health disparities require active research participation from oral health providers. Despite its importance, data on factors influencing research involvement across diverse regions and sectors in the Kingdom remain limited.

This study aimed to quantify participation in dental research-related activities reported by oral healthcare providers in KSA and to investigate its association with socio-demographic and professional characteristics, as well as practitioners’ perceptions of the R&D index. The null hypothesis is that there are no significant differences among healthcare providers in SA in dental research-related activities.

2. MATERIALS AND METHODS

3. RESULT

The study sample, comprising 243 oral health providers, offers a nuanced picture of the professional landscape in this sector (Table 1). The majority of respondents were male (61.3%), and a significant portion was over 35 years old (60.1%). The participants were almost equally divided between those working in governmental (52.7%) and private sectors (47.3%), indicating a balanced representation across different employment settings. A notable majority earned more than 20,000, suggesting a relatively high-income bracket for many in the sample. The geographical distribution of the participants' work locations from southern regions (32.5%) and the origins of their last degree, primarily from KSA (74.5%), highlight the local educational influence alongside international exposure. Most professionals were dentists (63.0%), with a majority holding clinical positions (89.7%), showcasing a strong focus on clinical roles within the sector.

Regarding their professional engagement, the data shows a varied pattern of direct patient contact: 41.6% had no direct contact, while others ranged from half a day to five days a week, indicating diverse roles and responsibilities within oral health provision. The number of patients seen daily also varied, with 48.1% seeing less than 8 patients, 43.2% serving exactly 8 patients, and a smaller group (8.6%) seeing more than 8 patients, reflecting differences in workload and patient interaction. Engagement in dental research over the past 12 months was clear, with 50.2% of respondents involved in research activities, indicating a strong research orientation among the sample. Additionally, 45.7% were named on a research funding application, and 54.7% presented a research paper at a conference, underscoring the active involvement of the sample in advancing dental knowledge and practice.

The findings from a survey of oral health providers in KSA, as presented in Table 2, highlight critical aspects of research engagement and professional development within the dental sector. A promising 34.6% of respondents see significant opportunities for developing their practice, indicating a supportive environment for professional growth. Moreover, 31.3% highlighted the importance of incorporating evidence-based practice into their work, affirming a commitment to research-informed dental care.

Despite this positive finding, several challenges are evident. A notable 26.7% of providers lack confidence in integrating research findings into their practice, with a similar proportion, 28.4%, unsure of how research directly affects their clinical decisions. Additionally, about a quarter of the participants struggle with research terminology (24.3%) and lack the necessary skills to effectively leverage library and digital resources (24.7%).

Yet, the interest in research utilization remains strong, with 32.5% of respondents keen on applying research in their clinical settings and 30.9% expressing a desire to enhance their understanding of research activities. This demonstrates a clear eagerness among dental professionals to overcome barriers and integrate research into practice, highlighting the potential for growth in research literacy and application in the dental sector.

Table 3 presents the results of independent t-tests and one-way ANOVA tests used to determine differences in the mean scores of the R&D index domains based on demographic details (such as gender, age, nationality), professional characteristics (including sector type, professional type, job title, years of experience, direct contact with patients), and work-related aspects (like monthly income, current work location, education level, number of working days, the average time of any treatment procedure for each patient, and the number of patients seen every day). The analysis of the associations between the R&D index domain scores and the participants' characteristics in dental research activities revealed varied findings across different variables. The findings indicate that gender differences do not significantly impact most R&D domains, except in R&D support, where males score marginally lower (p = 0.050). Age is a factor, with participants 35 years and younger demonstrating lower R&D intentions than those older, marked by a significant p-value (p = 0.013). Individuals working in government sectors exhibit higher R&D intentions compared to their private sector counterparts (p = 0.017), and non-Saudi nationals score significantly higher in R&D skills/aptitude than Saudi nationals (p = 0.005), although nationality does not significantly affect other domains. Income levels are related to R&D engagement, with those earning 10,000 or less exhibiting higher scores in R&D support (p = 0.003) and skills/aptitude (p = 0.021), and the most substantial intentions toward R&D (p < 0.001). Work location influences R&D intentions, particularly in the central and southern areas showing higher scores compared to other regions (p = 0.05). Higher education levels correlate with enhanced R&D intentions, notably for individuals with a bachelor’s degree (p = 0.026). Professionally, dentists score significantly higher in R&D support (p = 0.040), skills/aptitude (p = 0.024), and intentions (p = 0.011) than non-dental professionals. Clinical directors rank higher in almost all domains versus clinicians and administrators, highlighting the significant impact of job roles on R&D engagement. Experience also plays a role, with a positive association between years of experience and R&D intentions (p = 0.017). Direct patient contact does not markedly influence R&D domains. Yet, those working five days a week report higher R&D intentions (p = 0.013) than those working fewer days. The average treatment time impacts R&D intentions (p = 0.014), but the daily patient volume does not significantly affect R&D domains.

A multiple linear regression analysis was conducted to identify factors that influenced dental research participation among oral health providers in the past year, with a particular focus on the effects of R&D index domain scores, as detailed in Table 4. The analysis showed that R&D support was not a significant factor in research participation (p = 0.707). However, R&D skills/aptitude and R&D intention emerged as significant predictors of participation, with p-values of 0.020 and 0.010, respectively. These findings indicate that improvements in R&D skills/aptitude and fostering a strong intention towards research significantly enhance the likelihood of engaging in dental research. Collectively, these variables accounted for a modest portion of the variance in research participation, with an adjusted R^2 value of 0.005. Specifically, a unit increase in R&D skills/aptitude and R&D intention scores was associated with a 20.3% and 12.2% increase in the likelihood of dental research participation, respectively.

4. DISCUSSION

This study was carried out to provide insights into participation in research activities among oral health providers who work in all regions and sectors in KSA. Findings demonstrated that half of oral health providers had participated in dental research activities in the past 12 months. This is also supported by studies conducted by Pau et al. [4] and MA et al. [11], which found that one-third of participants are involved in dental research activities.

The null hypothesis is partially accepted as there are no significant differences among healthcare providers in KSA in dental research-related activities.

While the study presents promising outcomes, significant challenges remain unaddressed, impacting the effective integration of research findings into clinical practice. A notable concern is the evident lack of confidence among a substantial proportion of oral healthcare providers in applying research outcomes to their daily practice. This is mirrored by a similar fraction of participants who are uncertain about the direct implications of research on their clinical decisions, suggesting a disconnect between research findings and practical application in clinical settings. The lack of confidence in integrating research into practice highlighted the need for targeted educational initiatives that bridge the gap between theoretical knowledge and practical application. This is supported by Wang et al. (2020), who emphasize the importance of reforming educational methods to achieve better academic performance and demonstrate greater accuracy in diagnosing patient conditions and formulating treatment plans among dental students [12].

Furthermore, approximately one-quarter of the study participants reported difficulties in comprehending research terminology, as well as a lack of proficiency in utilizing library and digital resources to their advantage. This highlights a critical gap in the necessary skills required to navigate and leverage the wealth of available research, which could otherwise inform and enhance clinical practice significantly. Integrating research methodology and digital literacy training into the core curriculum of medical education could significantly enhance the ability of future healthcare providers to engage with and apply research findings effectively [13, 14].

Gender emerges as a critical determinant, with female dentists, particularly those earning a monthly income of less than 10,000 SAR, demonstrating higher levels of R&D support compared to their male counterparts. This observation may reflect a broader trend within the research community where female researchers often exhibit strong inclinations towards research activities. This could be due to gender-specific motivations or perceptions of research as a means of professional advancement in traditionally male-dominated fields. The observation of significant disparities in R&D support and intentions among dental research participants based on demographic and professional variables aligns with the findings that females had more positive perceptions of participating in dental research.¹¹ Additionally, dental schools should continue to recruit and support women faculty and consider programming aimed at encouraging academic productivity and advancement for women in academic dentistry [15].

Age and professional experience further differentiate R&D support and intentions, with younger dentists and those with less than 10 years of experience reporting greater engagement. This could be attributed to the more recent exposure of younger professionals to current educational practices that emphasize the importance of research in clinical excellence and increase support of research in KSA [16], as well as a possibly greater enthusiasm for new knowledge and innovations in the early stages of their careers [17]. The impact of age and professional experience on R&D intentions concurs with the findings of the study conducted in Malaysia that found that more positive perceptions of R&D skills and aptitude was statistically significantly associated with older respondents by the longitudinal study [4].

Educational level plays a significant role, with those holding a bachelor's degree showing higher R&D intentions. This finding supports the notion that foundational education in research principles and methodology can lay the groundwork for ongoing engagement in research activities throughout one’s career. It also suggests that advanced degrees might not be the only pathway to high R&D engagement, pointing instead to the importance of integrating research components within undergraduate curricula. Regarding the role of educational attainment, the analysis by Amir et al. and Yu et al. on the influence of undergraduate research experiences on professional research engagement offers insight [18, 19]. They argue that early exposure to research methodologies and principles can instill a lasting interest and capability in research activities, underscoring the value of integrating research components within undergraduate health science curricula.

The study also identifies the work setting as a key factor, with dentists working in the central region and in government sectors demonstrating higher R&D support and intentions. This could be reflective of regional disparities in research infrastructure and funding, as well as differences in organizational culture between government and private sectors, where government institutions may offer more support or opportunities for research activities. The influence of the work setting on R&D support and intentions among dentists, particularly in the central region and government sectors, parallels findings by Khayat (2022) [20], which indicated that the highest research activity occurred in the central region as Riyadh region and most productive corresponding government institution was King Saud University.

Additionally, the operational dynamics within the clinical setting, such as the number of working days and the average time spent with each patient, are shown to impact R&D intentions. Specifically, dentists who work 5 days a week and allocate approximately 30 minutes per patient exhibit stronger research intentions, potentially indicating that a balanced workload and sufficient patient interaction time can facilitate engagement in research activities without detracting from clinical responsibilities. This finding was opposite to the study results indicating that fewer workloads and adequate patient interaction times can significantly enhance healthcare professionals' capacity and inclination to engage in research, advocating for workplace adjustments to support research engagement [11].

This study found that R&D skills/aptitude and the intention to participate are key predictors of oral health providers' involvement in dental research activities within the past 12 months. Specifically, intention shows as a more significant factor than R&D support in determining research participation. To enhance engagement in dental research among oral health providers, it is essential to focus on areas such as increasing active participation through ongoing training for existing staff, expanding opportunities for research training and activities such as research writing and mentorship, and developing support for postgraduate programs that foster R&D initiatives among new oral health practitioners. Additionally, the study shows a considerable number of providers in KSA do not take part in research activities, which align with the findings of Pau et al. [4] and Shubayr et al. (2021) [11].

This research provides significant insights into the factors affecting oral health providers' participation in dental research within KSA, characterized by its comprehensive scope and valid methodology. By covering all regions in the KSA and sectors and employing a pre-validated questionnaire, the study ensures a broad and reliable understanding of the current research and development culture among dental professionals. The utilization of the R&D index offers an in-depth analysis, identifying R&D skills/aptitude and intentions as important predictors of research participation. However, the study is not without limitations, including potential response bias due to the online survey format and the cross-sectional design, which limits the ability to explore causality. Furthermore, the difficulty in accurately estimating the number of non-dentist oral health providers might lead to an incomplete picture of the sector. Despite these limitations, the study marks a significant step towards enhancing dental research engagement, suggesting a need for targeted strategies that focus on improving R&D skills and improving research intentions among oral health practitioners in KSA. Future research could build on these findings by exploring specific interventions and conducting longitudinal studies to address the identified gaps and further strengthen the dental research infrastructure.

CONCLUSION

This study represents a significant advancement in understanding the engagement of oral health providers in dental research within KSA. It has identified R&D skills/aptitude and intentions as crucial predictors of participation. Clearly, older dental professionals working in government sectors, earning a monthly income of less than 10,000 SAR, based in the central region, holding a bachelor's degree, in roles as dentists or clinical directors, with less than 10 years of experience, working five days a week and spending 30 minutes with each patient, exhibit a higher inclination towards participating in dental research.

The findings highlighted the importance of conducting and implementing specialized educational and training programs. These programs should emphasize research skills and their practical application to improve research involvement among oral health providers in the country. Additionally, fostering a research-supportive environment within dental institutions, enhancing mentorship programs, and integrating research methodologies into undergraduate and postgraduate curricula are essential steps to sustain and increase research engagement.

Moreover, efforts should be directed toward increasing funding opportunities, improving access to research resources, and encouraging interdisciplinary collaboration between universities, healthcare institutions, and policymakers. Raising awareness about the impact of research on clinical practice and patient outcomes is also crucial in motivating dental professionals to participate actively in research initiatives. Future studies should focus on longitudinal assessments to evaluate the effectiveness of research training programs and identify additional barriers to research participation among oral health providers in KSA.

REFERENCES